Addiction
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Review Meta Analysis Comparative Study
Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?
Although debates over the efficacy of oral naltrexone and acamprosate in treating alcohol use disorders tend to focus on their global efficacy relative to placebo or their efficacy relative to each other, the underlying reality may be more nuanced. This meta-analysis examined when naltrexone and acamprosate are most helpful by testing: (i) the relative efficacy of each medication given its presumed mechanism of action (reducing heavy drinking versus fostering abstinence) and (ii) whether different ways of implementing each medication (required abstinence before treatment, detoxification before treatment, goal of treatment, length of treatment, dosage) moderate its effects. ⋯ In treatment for alcohol use disorders, acamprosate has been found to be slightly more efficacious in promoting abstinence and naltrexone slightly more efficacious in reducing heavy drinking and craving. Detoxification before treatment or a longer period of required abstinence before treatment is associated with larger medication effects for acamprosate and naltrexone respectively.
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Review Meta Analysis
Evidence of HIV epidemics among non-injecting drug users in Iran: a systematic review.
In Iran, injecting drug users have been recognized as a high-risk group for HIV/AIDS for years. However, evidence of HIV epidemics in non-injecting drug users (non-IDUs) has also been found in recent years. The aim of this systematic review was to determine the prevalence of HIV in non-IDUs in Iran. ⋯ Iran is facing a major HIV epidemic among non-injecting illicit drug users, which necessitates an urgent preventive response.
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Review Meta Analysis Comparative Study
Deep brain stimulation compared with methadone maintenance for the treatment of heroin dependence: a threshold and cost-effectiveness analysis.
To determine the success threshold at which a theoretical course of deep brain stimulation (DBS) would provide the same quality of life (QoL) and cost-effectiveness for heroin dependence as methadone maintenance treatment (MMT). ⋯ The success rate, defined as the percentage of patients remaining heroin-free after 6 months of treatment, at which deep brain stimulation would be similarly cost-effective in treating opiate addiction to methadone maintenance treatment, is estimated at 49%.
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Review Meta Analysis
A systematic review and meta-analysis of the effectiveness of behavioural smoking cessation interventions in selected disadvantaged groups.
A systematic review and meta-analysis was conducted to assess the methodological quality and effectiveness of behavioural smoking cessation interventions targeted at six disadvantaged groups; the homeless, prisoners, indigenous populations, at-risk youth, individuals with low socio-economic status and individuals with a mental illness. ⋯ Few well-controlled trials have examined the most effective smoking cessation strategies for highly disadvantaged groups, especially among the homeless, indigenous smokers and prisoners. The use of behavioural smoking cessation interventions for some socially disadvantaged groups appears promising; however, overall findings are inconsistent. Further research is needed to establish the most effective interventions for vulnerable high-risk groups. Special attention should be given to increasing sample size and power, and to sound evaluation methodology to overcome methodological limitations of conducting research with these high-risk groups.
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Review Meta Analysis
Efficacy and safety of nicotine replacement therapy for smoking cessation in pregnancy: systematic review and meta-analysis.
To determine the efficacy and safety of nicotine replacement therapy (NRT) with or without behavioural support when used to support smoking cessation in pregnancy. ⋯ There is currently insufficient evidence to determine whether or not nicotine replacement therapy is effective or safe when used in pregnancy for smoking cessation; further research and, in particular, placebo-randomized controlled trials are required.